Provider Demographics
NPI:1578573457
Name:ONYEWU, CHUKWUMA OBI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUKWUMA
Middle Name:OBI
Last Name:ONYEWU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9841 GREENBELT RD STE 208
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6270
Mailing Address - Country:US
Mailing Address - Phone:240-786-1001
Mailing Address - Fax:240-786-1002
Practice Address - Street 1:9841 GREENBELT RD STE 208
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6270
Practice Address - Country:US
Practice Address - Phone:240-786-1001
Practice Address - Fax:240-786-1002
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0007073208VP0014X
MDD0065933208VP0014X
DCMD034554208VP0014X
VA0101235566208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMDCI2358OtherRAILROAD MEDICARE
DE1000025149Medicaid
DEDECF8249OtherRAILROAD MEDICARE
MD892LI499OtherMEDICARE
MDMDCI2358OtherRAILROAD MEDICARE
DE014047M28Medicare ID - Type Unspecified